{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:40:37Z","timestamp":1787841637733,"version":"build-2784847793"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To establish expert consensus on the diagnostic approach, treatment strategies, and fitness\u2010to\u2010dive assessment for divers with paranasal sinus disease, addressing the current lack of specific guidelines for this frequent diving\u2010related disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A rapid, conference\u2010based modified Delphi process was conducted with a panel of 14 Dutch otorhinolaryngologists, including four certified diving medicine specialists. Consensus was defined as more than 80% agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The panel achieved consensus on recommendations across four domains. For diagnosis, a comprehensive ENT evaluation including nasal endoscopy is recommended; low\u2010dose CT\u2010imaging is advised for persistent or recurrent cases to identify anatomical obstructions. Primary management is conservative, adhering to EPOS guidelines. Functional endoscopic sinus surgery (FESS) is reserved for cases refractory to medical therapy, particularly those with anatomical obstruction. Postoperatively, it is advised to refrain from diving for a minimum of 8\u2009weeks. Return to diving requires confirmed mucosal healing via endoscopy and a test dive under controlled conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This Delphi\u2010based consensus provides practical, evidence\u2010informed guidance for clinicians, bridging the gap in formal guidelines and promoting uniform evaluation and treatment strategies within diving medicine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70499","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:56:21Z","timestamp":1785239781000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Malta Consensus Statements on Paranasal Sinus Disorders in\n                    <scp>SCUBA<\/scp>\n                    Diving: Results of a Delphi Study"],"prefix":"10.1002","volume":"11","author":[{"given":"B. Y.","family":"Roukema","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Tergooi Medical Centre  Hilversum the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3725-463X","authenticated-orcid":false,"given":"H. F.","family":"van Waegeningh","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Tergooi Medical Centre  Hilversum the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. J. P.","family":"Bri\u00ebt","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Van Weel\u2010Bethesda Hospital  Dirksland the Netherlands"},{"name":"Department of Otorhinolaryngology Spijkenisse Medical Center  Spijkenisse the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. G.","family":"Bremer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Elkerliek Hospital  Helmond the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"Reinartz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Tergooi Medical Centre  Hilversum the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"issue":"3","key":"e_1_2_10_2_1","first-page":"109","article-title":"Barosinusitis: Comprehensive Review and Proposed New Classification System","volume":"8","author":"Vaezeafshar R.","year":"2017","journal-title":"Allergy and Rhinology (Providence)"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1580\/1080-6032(2003)014[0083:ESDIAA]2.0.CO;2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.28920\/dhm51.1.18-24"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-007-0353-6"},{"issue":"2","key":"e_1_2_10_6_1","first-page":"135","article-title":"SCUBA Diving and Otolaryngology, Part I: Diving Physics and Barotrauma of Descent","volume":"5","author":"Mallen J. R.","year":"2020","journal-title":"Laryngoscope Investigative Otolaryngology"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.2617"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.2616"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.28920\/dhm48.2.79-83"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.28920\/dhm54.4.287-295"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3357\/ASEM.3013.2011"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06034-3"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.28920\/dhm51.2.182-189"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-011-1742-4"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894211072353"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin20.601"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(21)00457-4"},{"issue":"2","key":"e_1_2_10_18_1","first-page":"144","article-title":"SCUBA Diving and Otolaryngology, Part II: Diving\u2010Related Ear and Sinus Disease","volume":"5","author":"Mallen J. R.","year":"2020","journal-title":"Laryngoscope Investigative Otolaryngology"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70499","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lio2.70499","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70499","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:16:31Z","timestamp":1787840191000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.70499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/lio2.70499"],"URL":"https:\/\/doi.org\/10.1002\/lio2.70499","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"2026-04-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70499"}}